日本血吸虫病数学模型及其应用研究
发布时间：2018-11-23 08:40
【摘要】： 血吸虫病是一种在世界范围内严重危害人类健康的传染病。目前，在实际防病、治病及科研等方面还存在着一系列阻碍工作有效、正确实施的问题。如广泛应用的病原诊断法低估实际感染率问题、如何进一步改进现有的病原诊断法以提高检测的敏感度问题、如何用感染率来正确估计日本血吸虫病的发病率以及如何对血吸虫病的感染情况进行短期预测等问题。本课题运用了传统流行病学和统计学方法，并引进数学模型技术针对以上问题进行进一步探讨。 一、日本血吸虫卵计量变异的数学模型及其应用研究 目的：进一步了解血吸虫病在我国的流行程度及特征，分析虫卵计量变异的影响因素，建立、检验和应用虫卵计量变异的数学模型。 方法：在江西省和安徽省选取典型的日本血吸虫病流行区进行虫卵计量变异的现场研究和必要的流行病学调查，在全面了解虫卵计量变异的基础上建立和检验虫卵计量变异的数学模型，应用数学模型绘制估计人群“实际”感染率的袖珍图并对袖珍图的有效性进行检验。 结果：1、居民的感染率和感染度较以往资料相比有明显下降，在不同性别、年龄、职业组中感染率无显著性差异。2、单次改良Kato法明显低估了感染率和人群感染度，并高估阳性者感染度。3、改良取样方法有利于提高检出率，且在感染度较低的人群效果更为明显。4、感染度与虫卵变异系数呈负相关。5、建立虫卵计量变异的随机模型，用实际观察资料对模型参数进行估计，，并验证了模型的有效性。6、应用该模型绘制了可以估计人群“实际”感染率的袖珍图，用现场资料对该图有效性进行验证，该图的预测值与实际感染率拟合良好。 结论：1、由于积极有效的综合防治措施，以及疫区易感人群的大量流失，血吸虫病的感染率较以往有明显下降，疾病原有的流行特征也发生了一定的改变。2、感染度是导致个体内虫卵计量变异的最终原因。3、成功建立并检验了虫卵计量变异的数学模型，利用数学模型绘制并检验了可以估计人群“实际”感染率的袖珍图。 二、估计日本血吸虫病发病人数数学模型的建立及应用 目的：估计血吸虫病的发病人数，可以帮助WHO和中国卫生部准确计算血吸虫病导致的疾病负担及全球疾病负担，以便更合理有效的分配卫生资源。 方法：通过收集历史文献以及血吸虫病监测点年报中有关血吸虫感染率和发病率的资料，以Logistic回归模型为基础，建立估计血吸虫病的发病人数的数学模型。 结果：血吸虫的感染率与多种症状和体征(24小时以及2周内腹痛、24小时以及2周内腹泻、肝剑突下＞3cm、脾海氏一、二级、腹水、巨脾)的发病率有相关关系，与肝锁骨下＞2cm无相关关系。 结论：所建模型可以应用于估计由日本血吸虫感染导致的发病率。 三、预测血吸虫感染情况的时间序列模型 目的：利用时间序列模型对血吸虫病的感染情况进行准确快速的短期预测，为政府决策部门合理地分配有限的医疗资源提供重要参考依据。 方法：收集湖南省某血吸虫病监测点1990-2003年报中血吸虫病感染情况的相关资料，采用时间序列模型中应用范围很广泛的求和自回归移动平均模型即ARIMA(p，d，q)模型对血吸虫病的感染率和感染度进行预测。 结果：运用ARIMA模型对该监测点男性、女性及合计的血吸虫病感染率和感染度进行预测，其相对误差分别为3.8％、11.9％、11.4％、5.0％，所有实测值均落在预测值的95％可信区间内。 结论：ARIMA模型预测效果良好，可以作为一种有效的工具应用于血吸虫病情的定量预测。
[Abstract]:Schistosomiasis is an infectious disease that is seriously harmful to human health in the world. At present, there are a series of problems that hinder the effective and correct implementation of the work in the aspects of disease prevention, treatment and scientific research. such as the use of a pathogenic diagnostic method for underestimating the actual infection rate problem, and how to further improve the existing pathogen diagnosis method to improve the detection sensitivity problem, How to use the infection rate to estimate the incidence of schistosomiasis in Japan and how to make short-term prediction of the infection of schistosomiasis. In this paper, the traditional epidemiological and statistical methods were used, and the mathematical model was introduced to further study the above problems. I. The Mathematical Model of the Measurement and Variation of the Egg of Schistosoma japonicum The purpose of the model and its application is to study the prevalence and characteristics of schistosomiasis in China, and to analyze the influencing factors, establishment and test of the measurement variation of the eggs. The mathematical model of the measurement and variation of the eggs of the eggs was carried out in Jiangxi and Anhui province, and the field study and necessary epidemiological investigation were carried out in the typical Japanese schistosomiasis endemic area in Jiangxi and Anhui province. On the basis of the variation of quantity, the mathematical model of the measurement variation of the eggs is established and tested, and the estimated population
[Abstract]:Schistosomiasis is an infectious disease that is seriously harmful to human health in the world. At present, there are a series of problems that hinder the effective and correct implementation of the work in the aspects of disease prevention, treatment and scientific research. such as the use of a pathogenic diagnostic method for underestimating the actual infection rate problem, and how to further improve the existing pathogen diagnosis method to improve the detection sensitivity problem, How to use the infection rate to estimate the incidence of schistosomiasis in Japan and how to make short-term prediction of the infection of schistosomiasis. In this paper, the traditional epidemiological and statistical methods were used, and the mathematical model was introduced to further study the above problems. I. The Mathematical Model of the Measurement and Variation of the Egg of Schistosoma japonicum The purpose of the model and its application is to study the prevalence and characteristics of schistosomiasis in China, and to analyze the influencing factors, establishment and test of the measurement variation of the eggs. The mathematical model of the measurement and variation of the eggs of the eggs was carried out in Jiangxi and Anhui province, and the field study and necessary epidemiological investigation were carried out in the typical Japanese schistosomiasis endemic area in Jiangxi and Anhui province. On the basis of the variation of quantity, the mathematical model of the measurement variation of the eggs is established and tested, and the estimated population
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